Family Planning Counseling
Most women don’t realize that they are pregnant until they are a few weeks along and this essential nutrient can help prevent birth defects during the critical first eight weeks of fetal formation. It is also recommended that you have your immunity for Rubella, Varicella (Chicken Pox) and Hepatitis B checked. If you are not immune to either Rubella or Varicella, you should receive these injections and wait three months before attempting conception. If you are not immune to Hepatitis B, you can receive the series at any time and no waiting period is required before you try to expand your family.
We strongly encourage women to know and understand their bodies. Knowing what is normal for you and what is not normal in terms of your health is very important. We recommend that you wash your breasts with your bare hands and utilize a monthly visual inspection of your bare breasts in the mirror to detect breast changes. Some important signs to look for are:
- Lumps: Breast cancer lumps vary and may be hard or soft and have rounded or uneven edges.
- Swelling of part of the breast
- Skin irritation or dimpling
- Nipple pain or the nipple turning inward
- Red or scaly appearance of the nipple or breast skin
- Nipple discharge other than breast milk
- A lump in the underarm area
REMEMBER: These signs and symptoms do not necessarily mean that you have breast cancer. However, you should tell your doctor right away about any lump in the breast or underarm area and any changes in the skin of the breast, nipple, or areola (the area around the nipple).
Abnormal Pap Smears
ASCUS– Atypical Squamous Cells of Undetermined Significance is a low-grade abnormal pap smear. Sometimes having intercourse close to your Pap smear being done, an infection, or even menopause can cause your Pap smear to come back “abnormal”. We usually recommend that the first time you have an ASCUS Pap that it be repeated in 3-6 months. Two ASCUS results in a row will usually lead to a recommendation for colposcopy.
LSIL – Low-Grade Squamous Intraepithelial Lesion (sometimes referred to as CIN-I, which stands for Cervical Intraepithelial Neoplasia) is still considered a low-grade abnormality, but warrants further investigation. A repeat Pap smear in 3-4 months or a colposcopy is recommended. This type of abnormality is usually caused by the HPV virus. A vaccination against HPV is very close to being released, but it is meant as a preventative for those who are currently unaffected rather than a cure.
HSIL – High-Grade Squamous Intraepithelial Lesion (also known as CIN-2 or CIN-3) requires colposcopy with biopsy within 30 days which may demonstrate a need for LEEP (loop electosurgial excision procedure) or cryotherapy (freezing of the cervix). Follow-up Pap smears after the LEEP or cryotherapy are frequent to make sure new high-grade growth does not return. The schedule is usually to perform “Re-Paps” every 3-4 moths for a year then every six months for a year. The annual exam schedule can be resumed when all of these Pap smears have been normal (or no more than one ASCUS).
- Risk Factors for Cervical Cancer
- Tobacco use
- Long-term HPV infection
- Multiple sex partners, especially partners who engage in risky behaviors
- Exposure to HPV, especially high risk strains
- Failure to receive treatment at an early stage, when cervical cancer may be curable
- Knowing a partner for less than 8 months before engaging in sexual intercourse
- Sexual activity before age 20